What is the initiating event that leads to the development of atherosclerosis?

Injury to the endothelial cells that line the artery walls

Release of the platelet-deprived growth factor

Macrophages adhere to vessel walls

Release of the inflammatory cytokines

Answer and Explanation

The Correct Answer is A

A. Injury to the endothelial cells that line the artery walls: The development of atherosclerosis begins with damage to the endothelial cells of the arterial wall. This injury can be caused by various factors, including hypertension, smoking, high cholesterol, and diabetes. Once the endothelium is injured, it becomes more permeable, allowing lipids and inflammatory cells to penetrate and accumulate, leading to the formation of atherosclerotic plaques.

B. Release of the platelet-derived growth factor: While platelet-derived growth factor (PDGF) plays a role in the proliferation of smooth muscle cells and the progression of atherosclerosis, it is not the initiating event. PDGF is released in response to endothelial injury and inflammation but does not cause the initial damage itself.

C. Macrophages adhere to vessel walls: The adherence of macrophages to the vessel walls occurs after the initial endothelial injury. Once the endothelium is damaged, macrophages migrate to the site and contribute to the inflammatory response and plaque formation, but this is not the initiating event.

D. Release of inflammatory cytokines: Inflammatory cytokines are part of the response that follows endothelial injury and play a role in the progression of atherosclerosis. However, the release of these cytokines is a consequence of the initial injury rather than the initiating event.

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Free Nursing Study Resources

Correct Answer is ["C","D","E"]

Explanation

A. Expecting copious amounts of frothy, pink sputum: This symptom is typically associated with left-sided heart failure or pulmonary edema, where fluid accumulates in the lungs, leading to the production of frothy, pink sputum. It is not a classic manifestation of right-sided heart failure.

B. Fine crackles throughout both lung fields: Fine crackles are more indicative of left-sided heart failure due to fluid accumulation in the lungs (pulmonary congestion). In right-sided heart failure, the primary issues relate more to systemic congestion rather than pulmonary congestion.

C. +pitting edema in lower extremities: Right-sided heart failure often leads to fluid retention and peripheral edema due to increased venous pressure. Pitting edema in the lower extremities is a common clinical manifestation in patients with cor pulmonale and right-sided heart failure.

D. Altered level of consciousness: This can occur due to decreased cardiac output and resulting reduced cerebral perfusion. In right-sided heart failure, especially in advanced stages, fluid overload can lead to increased intracranial pressure, contributing to altered mental status.

E. Jugular vein distention: Jugular vein distention is a classic sign of right-sided heart failure. Increased pressure in the right atrium due to fluid overload results in distended neck veins, indicating elevated venous pressure.

A. A 79 year old lifetime smoker who is complaining of shortness of breath and pain on deep inspiration B. An 88 year old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke C. An 81 year old smoker who has increased exercise intolerance, a fever and increased white blood cells D. An 81 year old male who has a productive cough and recurrent respiratory infections

Correct Answer is A

Explanation

A. A 79-year-old lifetime smoker who is complaining of shortness of breath and pain on deep inspiration: Chronic obstructive pulmonary disease (COPD) is most commonly seen in individuals with a significant smoking history. Progressive shortness of breath is a hallmark symptom of COPD, resulting from chronic airway inflammation and airflow limitation. While pain on deep inspiration is not a classic COPD symptom, it could indicate pleuritic involvement or hyperinflation-related chest discomfort.

B. An 88-year-old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke: Acute shortness of breath and airway constriction in response to tobacco smoke suggests an asthma-like reaction rather than COPD. COPD symptoms tend to be persistent and progressive rather than episodic.

C. An 81-year-old smoker who has increased exercise intolerance, a fever, and increased white blood cells: Fever and increased white blood cells indicate an acute infection rather than chronic lung disease. While COPD exacerbations can cause worsening symptoms, an isolated fever and elevated white blood cells suggest pneumonia or another infectious process rather than COPD alone.

D. An 81-year-old male who has a productive cough and recurrent respiratory infections: A productive cough and recurrent respiratory infections are common in chronic bronchitis, a component of COPD. However, this presentation alone is not specific to COPD, as other conditions, such as bronchiectasis, can also cause these symptoms.

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What is the initiating event that leads to the development of atherosclerosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Upon admission to the ICU, a client with a history of cor pulmonale will likely be exhibiting which clinical manifestations of right-sided heart failure? Select all that apply. (Select All that Apply.)

Correct Answer is ["C","D","E"]

Explanation

Which long-term resident is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)?

Correct Answer is A

Explanation

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